Japanese Data Research Articles

Association between Empirical Anti-Pseudomonal Antibiotics and Progression to Thoracic Surgery and Death in Empyema: Database Research.

Evidence on the optimal antibiotic strategy for empyema is lacking. Our database study aimed to evaluate the effectiveness of empirical anti-pseudomonal antibiotics in patients with empyema. We utilised a Japanese real-world data database, focusing on patients aged ≥40 diagnosed with empyema, who underwent thoracostomy and received intravenous antibiotics either upon admission or the following day. Patients administered intravenous vasopressors were excluded. We compared thoracic surgery and death within 90 days after admission between patients treated with empirical anti-pseudomonal and non-anti-pseudomonal antibiotics. Cause-specific hazard ratios for thoracic surgery and death were estimated using Cox proportional hazards models, with adjustment for clinically important confounders. Subgroup analyses entailed the same procedures for patients exhibiting at least one risk factor for multidrug-resistant organisms. Between March 2014 and March 2023, 855 patients with empyema meeting the inclusion criteria were enrolled. Among them, 271 (31.7%) patients received anti-pseudomonal antibiotics. The Cox proportional hazards models indicated that compared to empirical non-anti-pseudomonal antibiotics, empirical anti-pseudomonal antibiotics were associated with higher HRs for thoracic surgery and death within 90 days, respectively. Thus, regardless of the risks of multidrug-resistant organisms, empirical anti-pseudomonal antibiotics did not extend the time to thoracic surgery or death within 90 days.

Impact of financial support expansion on restaurant entries and exits during the COVID-19 pandemic

AbstractThis study examines the impact of an expansion of financial support to compensate for the business hour restrictions during the early COVID-19 pandemic on the entry of dine-in restaurants in the market. During this period, the local governments provided financial support to all restaurants to alleviate the urgent need for relief. This support was given regardless of their past performance, and it coincidentally provided an opportunity for new entrants that met certain criteria to receive support. Based on Japanese administrative data and a difference-in-differences estimation, our study shows that the expansion of financial support led to an increase in the number of dine-in restaurants. We also observed that the impact is more significant in areas with lower opening and operating costs, but it does not vary based on an index of potential sales. These results confirm that indiscriminate reduction of entry barriers could lead to the entry of less profitable and marginal new firms. Moreover, financial support led to a decrease in restaurant exits, especially of low-productive ones.

Real-world progression-free survival and overall survival of palbociclib plus endocrine therapy (ET) in Japanese patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer in the first-line or second-line setting: an observational study

BackgroundA recent large real-world study conducted in the United States reported the effectiveness of palbociclib plus aromatase inhibitor in HR+/HER2− advanced breast cancer (ABC). However, local clinical practice and available medical treatment can vary between Japan and Western countries. Thus, it is important to investigate Japanese real-world data. This observational, multicenter study (NCT05399329) reports the interim analysis of effectiveness of palbociclib plus ET as first-line or second-line treatment for HR+/HER2− ABC by estimating real-world progression-free survival (rwPFS) and overall survival (OS) in Japanese routine clinical practice.MethodsReal-world clinical outcomes and treatment patterns of palbociclib plus ET were captured using a medical record review of patients diagnosed with HR+/HER2− ABC who had received palbociclib plus ET in the first-line or second-line treatment across 20 sites in Japan. The primary endpoint was rwPFS; secondary endpoints were OS, real-world overall response rate, real-world clinical benefit rate, and chemotherapy-free survival.ResultsOf the 677 eligible patients, 420 and 257 patients, respectively, had received palbociclib with ET as first-line and second-line treatments. Median rwPFS (95% confidence interval) was 24.5 months (19.9–29.4) for first-line and 14.5 months (10.2–19.0) for second-line treatment groups. Median OS was not reached in the first-line group and was 46.7 months (38.8-not estimated) for the second-line group. The 36-month OS rates for de novo metastasis, treatment-free interval (TFI) ≥ 12 months, and TFI < 12 months were 80.2% (69.1–87.7), 82.0% (70.7–89.3), and 66.0% (57.9–72.9), respectively.ConclusionThe addition of palbociclib to ET was effective for treating HR+/HER2− ABC in Japanese routine clinical practice.

Patient Journey of Generalized Pustular Psoriasis: A Real-world Study Using Data-mining Methods and Japanese Claims Data.

Patient Journey of Generalized Pustular Psoriasis: A Real-world Study Using Data-mining Methods and Japanese Claims Data.

Impact of El Niño Southern Oscillation on the first inter-monsoon rainfall over Sri Lanka in the post-El Niño years

Sri Lanka has a tropical monsoon climate. The first intermonsoon (FIM) season is one of four rainfall seasons. Previous investigations have explored the concurrent ramifications of the El Niño Southern Oscillation (ENSO); however, its impact on seasonal rainfall patterns in the country in the post-El Niño years remains unexplored. This study aims to investigate anomalous FIM rainfall in Sri Lanka during the post-El Niño years. Weather station rainfall data from the Department of Meteorology for 114 stations for 1975–2019, Japanese 55-year reanalysis data, and COBE sea surface temperature data were used in this study. A significant negative correlation between rainfall at most stations and the preceding year’s November, December, and January Niño3.4 index (NDJ Niño3.4) was identified for the FIM season. All three super El Niño events and one of the two strong El Niño events agree with the above results, showing a clear negative rainfall anomaly pattern. The Indo-western Pacific Ocean Capacitor effect was identified as the cause of rainfall reduction during the FIM season in Sri Lanka and in contrast, the post-El Niño season in 1988 exhibited a positive rainfall anomaly. A rapid transition from El Niño to La Niña and the associated atmospheric conditions were identified as significant contributors to these features. The findings of this study will help overcome this research gap and improve the accuracy of seasonal forecasts for the country.

Glycemic control of once-weekly and other administration frequencies for DPP-4 inhibitor in patients with type 2 diabetes: a real-world retrospective cohort study.

To assess the glycemic control of once-weekly (QW) and other administration frequencies for dipeptidyl peptidase-4 inhibitors (DPP-4i) in patients with type 2 diabetes in a real-world setting. A retrospective cohort study used Japanese medical claims data and medical check-up data between December 2015 and February 2020. Patients with type 2 diabetes had been newly prescribed a DPP-4i regimen of once-daily (QD), twice-daily (BID), or QW administration and had hemoglobin A1c (HbA1c) values from regular medical check-ups. HbA1c values and proportion of patients achieving their HbA1c target were assessed. Multivariable analyses were conducted to examine the association between DPP-4i regimen and achievement of HbA1c target. Of the analysis population (N = 7229), 6098 patients were prescribed the QD regimen, 772 BID, and 359 QW. Mean HbA1c before exposure to DPP-4i was 7.31 ± 1.20% (mean ± standard deviation) for QD, 7.64 ± 1.47% for BID, and 7.06 ± 0.96% for QW, decreasing after DPP-4i exposure to 6.71 ± 0.78%, 6.77 ± 0.84%, and 6.59 ± 0.67%, respectively. HbA1c < 7% was achieved in 72.1% of patients for QD, 69.0% for BID, and 79.1% for QW. On multivariable analysis, the odds ratio (95% confidence interval) for HbA1c < 7.0% in patients < 65years of age was 0.97 (0.73-1.30) for BID and 0.90 (0.57-1.42) for QW compared to QD. Similar achievement of HbA1c target was noted in each regimen for patients age ≥ 65years and for age ≥ 65years with multimorbidity. In this study under real-world conditions, glycemic control for the DPP-4i QW regimen was similar to that for QD and BID. The online version contains supplementary material available at 10.1007/s13340-024-00718-5.

Developing an AI-based prediction model for anaphylactic shock from injection drugs using Japanese real-world data and chemical structure-based analysis.

This study aims to develop an AI-based prediction model for injection drugs that cause anaphylactic shock using Japanese Real-World Data (JADER database) and chemical structure-based analysis. Data sourced from the JADER database included adverse drug reaction reports from April 2004 to December 2020. Only drugs with an adverse reaction named "anaphylactic shock" were selected for analysis. For model building, various models were constructed to predict anaphylactic shock-inducing drugs, such as logistic regression, LASSO, XGBoost, RF, SVM, and NNW. These models used chemical properties and structural similarities as feature variables. Dimension reduction was applied using principal component analysis. The dataset was split into training (80%) and validation (20%) sets. Six different models were trained and optimized through fivefold cross-validation. From April 2004 to December 2020, 947 drugs with the adverse reaction name "anaphylactic shock" were extracted from the JADER database. 320 drugs were excluded due to analytical challenges, and another 400 were removed due to their administration route. 227 drugs were finalized as target medicines. For model validation, the performance of each model was evaluated based on metrics like AUCs of ROC curve, sensitivity, and specificity. Additionally, two ensemble models, constructed from the six models were assessed using bootstrap sampling. Interestingly, it was identified that mepivacaine structural similarity had the highest importance in the final model. The study successfully developed an AI-based prediction model for anaphylactic shock inducing-injection drugs. The model would offer potential for drug safety evaluation and anaphylactic shock risk assessment.

Comparison of medication persistence and adherence in type 2 diabetes using a once-weekly regimen of DPP-4 inhibitor compared with once-daily and twice-daily regimens: a retrospective cohort study of Japanese health insurance claims data.

Assess medication persistence and adherence for dipeptidyl peptidase-4 inhibitors (DPP-4i) administered once weekly (QW), once daily (QD), and twice daily (BID) among patients with type 2 diabetes (T2D), and explore factors associated with discontinuation and non-adherence for DPP-4i regimens. This retrospective T2D cohort study used medical claims data for three DPP-4i regimens in patients newly prescribed DPP-4i between December 2016 and February 2019. Medication persistence rates were calculated at 3, 6, and 12months by the Kaplan-Meier method. Adherence was measured as Proportion of Days Covered (PDC). We used Cox proportional hazards models for DPP-4i discontinuation and logistic regression models for non-adherence. In the analysis population of 52,762 patients, DPP-4i prescriptions were 84.2% QD, 11.8% BID, and 4.0% QW. Medication persistence rates were similar up to 6 months for all regimens: approximately 90% at 3 and 80% at 6 months. The 12-month persistence rates for QD, BID, and QW were 74.8%, 67.5%, and 68.0%, respectively. Median PDC was 94.0% for QD, 91.8% for BID, and 93.2% for QW. Five specific factors were associated with discontinuation: BID or QW regimen, younger age, no concomitant medications, comorbid dementia, and comorbid chronic pulmonary disease. Non-adherence was associated with those factors plus male sex and treatment at clinics with 0-19 beds. The 12-month medication persistence rates were highest for QD, followed by QW and then BID. Adherence was similar for all three regimens. Medication persistence for DPP-4i may be improved by tailoring regimens to patient characteristics and needs. The online version contains supplementary material available at 10.1007/s13340-024-00714-9.

Risk identification in Japanese consumer product injury data throughout an ontology-based knowledge base

Risk identification and further risk assessment of consumer product injury data are critical tools for accident prevention. However, in Japan, existing risk assessment methods face challenges due to issues such as inconsistent semantic understanding of risk-related vocabulary among Japanese analysts, posing obstacles to the effective identification and assessment of risk information. This study develops an ontology-based knowledge base (JCPRI-KB), which includes an ontology (JCPRI-Onto) and a total of 41 standardised vocabulary sets, for the risk information identification and standardization of consumer product injury data in Japan. A graph database was used to represent and store the risk knowledge of JCPRI-KB. Finally, the JCPRI-KB is applied for a case study of risk identification and further risk assessment of child product injury data. The risk assessment results of this study demonstrate that the JCPRI-KB offers a promising new approach to the field of consumer product safety in Japan, contributing to the enhancement of accuracy and efficiency in risk identification and thus promoting consumer product safety.

Exploring the relationship between development aid and FDI from developed countries in developing countries: empirical insights from Japanese firm-level data

Exploring the relationship between development aid and FDI from developed countries in developing countries: empirical insights from Japanese firm-level data

Evaluating the association of body mass index with COVID-19 severity and mortality using Japanese administrative claims data

Obesity is a risk factor for aggravation of and mortality from coronavirus disease 2019 (COVID-19). We aimed to investigate the relationship between COVID-19 and Body Mass Index (BMI) in the Japanese population. We used administrative claims data from an advanced treatment hospital in Japan and extracted data from patients hospitalized for COVID-19. The exposure variable was BMI measured at the time of admission, and the study outcomes were progression to critical illness and death. Analyses were performed for each age group. Overall, 58,944 patients met the inclusion criteria. The risk of critical illness increased monotonically with higher BMI. In contrast, the relationship between BMI and mortality follows a J-shaped curve; being underweight and obese are risk factors for mortality. When stratified by age, similar trends were observed for both critical illness and mortality. A higher BMI is a risk factor for the progression of COVID-19 severity, whereas both lower and higher BMIs are risk factors for mortality in the Japanese population.

The Japanese version of the reduced morningness-eveningness questionnaire

ABSTRACT Circadian typology, or “morningness” and “eveningness,” is generally assessed using the Morningness-Eveningness Questionnaire (MEQ), a 19-item scale that could be burdensome in large-scale surveys. To overcome this, a 5-item version known as the reduced morningness-eveningness questionnaire (rMEQ), which is sensitive to the assessment of circadian typology, was developed; however, a validated Japanese version of the rMEQ is yet to be established. This study aimed to develop and validate the Japanese version of the rMEQ. Five essential items for the rMEQ were selected from existing Japanese MEQ data (N = 2,213), and the rMEQ was compiled. We conducted a confirmatory factor analysis for the psychometric properties of the rMEQ and confirmed its robust one-factor structure for evaluating morningness-eveningness (GFI = 0.984, AGFI = 0.951, CFI = 0.935, and RMSEA = 0.091). Reliability was evaluated via internal consistency of rMEQ items using Cronbach’s α and McDonald’s ω, and the values were 0.618 and 0.654, respectively. The rMEQ scores strongly correlated with MEQ (ρ = 0.883, p < 0.001), and classification agreement (Morning, Neither, and Evening types) between rMEQ and MEQ was 77.6% (Cramer’s V = 0.643, Weighted Cohen’s κ = 0.72), confirming the validity. The Japanese rMEQ may be a valuable tool for the efficient assessment of circadian typologies.

The decline in the labor share: Evidence from Japanese manufacturers’ panel data

This paper replicates Kehrig and Vincent (2021) using Japanese data and tests whether the overall labor share decline is led by an increase in low-labor-share firms. The results can be summarized as follows. First, although the labor share of median firms did not rise while the overall labor share was declining, the rate of decline in the labor share of the median firm was slower than the overall rate of decline. Second, the value-added share of firms with a low labor share increased while their salary share did not increase when the overall labor share declined. Third, entry and exit are not important to the decline in overall labor share, as in the United States. Fourth, the role of firms with an extremely low labor share, say under decile, which is a good explanation of the change in labor share in the United States, is limited in Japan. Fifth, the change in actual labor share is very similar to ∑ωi,initialλit, the product of the initial value-added share and labor share at the time. Sixth, firms that increased their value-added share tended to decrease their labor share.

Clinical and Economic Outcomes of Patients with Osteoporosis Undergoing Spine Fusion Surgery in Japan.

Spinal fusion surgery with instrumentation is a treatment of choice for many spinal disorders; however, there is little data related to factors associated with early and late outcomes, especially among patients with poor bone quality (e.g., osteoporosis). We conducted this study to characterize the epidemiology and outcomes of patients undergoing spinal fusion surgery with instrumentation in Japan, especially in patients with poor bone quality and those needing additional fixation methods. This retrospective observational study used real-world health insurance claims data from the Japanese Medical Data Vision. Adult patients undergoing an index spinal fusion procedure from April 1, 2010, to September 30, 2017, with procedural details, length of stay (LOS), total in-hospital costs, spine-related reoperation, all-cause readmission, and postoperative complications recorded. Data were summarized descriptively overall, by osteoporosis status, and additional fixation method used, and were analyzed in bivariate analyses. Multivariate logistic and linear regressions were used to explore associations between covariates and variables of interest. A total of 22,932 patients (mean age, 67.3 years; 51.2% male) met the study criteria and were included. A total of 5,288 (23.0%) patients had osteoporosis, and 2,507 (10.9%) needed additional fixation methods; these patients were older, more frequently female, and had higher Elixhauser comorbidity index scores. Osteoporosis and additional fixation use were also associated with longer LOS, higher hospital costs, and higher rates of complications. Patients with osteoporosis and those needing additional fixation methods have a higher risk for procedural and postoperative complications, reoperation, longer LOS, and higher total hospital costs.

Next generation mobile edge computing wireless sensor network based Japanese remote interactive practical teaching platform

To solve the problem of lack of practice in Japanese teaching, a design of a Japanese remote interactive practical teaching platform based on the modern edge computing-based wireless sensor network is proposed. In terms of hardware, it mainly refits interactive mobile edge computing, wireless sensor networks, microprocessors, and other equipment, and adjusts the interface circuit. The Japanese teaching data and relevant Japanese teaching resources generated in the process of Japanese Teaching of practical courses are stored in the corresponding database table according to a certain format, and the logical relationship between database tables is used to update the database. The software function of the platform is designed with the support of a database and hardware equipment. It consists of multiple modules, including platform user roles, interactive practical teaching and management, practical resource management and distribution, practice project information release, practice investigation statistics, and platform operation safety. Through the above design, the operation of a Japanese remote interactive practical teaching platform is realized. The test results show that there is no significant difference in the function realization of the design platform, but when multiple users are online at the same time, the interaction performance of the design platform is stronger, that is, the operation performance of the platform has obvious advantages.

Decay Characteristics of Neutron Excess Potassium Nuclei

In neutron star mergers, neutron excess nuclei and the r-process are important factors governing the production of heavy nuclear systems. A single-particle model evaluation of potassium nuclei suggests that the heaviest Z = 19 nucleus will have mass 69 with filling of the 1g9/2 neutron shell. A = 55 – 69 potassium isotopes have limited experimental half-life data, but the model predicts beta decay half-lives in the range of 0.315 – 9.23 ms. Based on previous calculations for Z = 9 - 18, 20, 26, and 30 systems and comparisons to the 55K – 59K, 61K, and 63K calculations, summarized in the Japanese Nuclear Data Compilation, the single-particle model results likely overestimate the half-lives of A = 55 – 69 neutron excess potassium nuclei.

Claims-based Frailty Index in Japanese Older Adults: A Cohort Study Using LIFE Study Data.

We aimed to assess whether the United States-developed Claims-based Frailty Index (CFI) can be implemented in Japanese older adults using claims data. We used the monthly claims data and certification of long-term care (LTC) insurance data of residents from 12 municipalities from April 2014 to March 2019. The 12 months from first recording was defined as the "baseline period," and the time thereafter as the "follow-up period". Participants aged ≥65 years were included, and those with no certified LTC insurance or who died at baseline were excluded. New certification of LTC insurance and all-cause mortality during the follow-up period were defined as outcome events. CFI categorization consisted of three steps including: 1) using 12 months deficit-accumulation approach that assigned different weights to each of the 52 items; 2) the accumulated score to derive the CFI; and 3) categorizing the CFI as "robust" (<0.15), "prefrail" (0.15-0.24), and "frail" (≥0.25). Kaplan-Meier survival curves and Cox proportional hazard models were used to determine the association between CFI and outcomes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. There were 519,941 participants in total. After adjusting for covariates, the severe CFI category had a high risk of certification of LTC insurance (prefrail: HR 1.33; 95% CI, 1.27-1.39 and frail: HR 1.60; 95% CI, 1.53-1.68) and all-cause mortality (prefrail: HR 1.44; 95% CI, 1.29-1.60 and frail: HR 1.84; 95% CI, 1.66-2.05). This study suggests that CFI can be implemented in Japanese claims data to predict the certification of LTC insurance and mortality.

The development and analysis of a Japanese modern comprehensive clinical data management training program

BackgroundClinical data management (CDM) collects, integrates, and makes data available. It plays a vital role in clinical research. However, there are few opportunities for Japanese clinical data managers to learn about its systematic framework, particularly in academic research organizations. While Japanese-language CDM training exists, its effectiveness in a Japanese context requires clarification. ObjectivesWe aimed to develop an advanced program of instruction for professionals to understand CDM and to determine the effectiveness of the training program. Methods and resultsWe developed an advanced program including risk-based monitoring and the Clinical Data Interchange Standards Consortium on a trial basis for clinical data managers to provide them with a comprehensive understanding of CDM. Fifty-two people attended the program and reported that they were highly satisfied with it. ConclusionsTo provide comprehensive CDM training in Japan, it is imperative to continue improving the content and develop an advanced program. Due to the recent tightening of clinical research regulations and the development and dissemination of various systems for conducting clinical research, the competency-based educational program requires further development.

Androgen deprivation therapy-related fracture risk in prostate cancer: an insurance claims database study in Japan

IntroductionAndrogen deprivation therapy (ADT) is widely used for the treatment of prostate cancer. ADT is associated with reduced bone density leading to an increased risk of osteoporotic fracture. The objective of this retrospective cohort study was to quantify fracture risk in men treated with ADT for prostate cancer in real-world practice in Japan.Materials and methodsData were extracted from the Japanese Medical Data Vision (MDV) database. Men initiating ADT for treatment of prostate cancer between April 2010 and March 2021 were identified and matched to a cohort of prostate cancer patients not taking ADT using a propensity score. Fracture rates were estimated by a cumulative incidence function and compared between cohorts using a Cox cause-specific hazard model. Information was extracted on demographics, comorbidities and bone densitometry.Results30,561 men with PC starting ADT were matched to 30,561 men with prostate cancer not treated with ADT. Following ADT initiation, <5% of men underwent bone densitometry. Prescription of ADT was associated with an increased fracture risk compared to not taking ADT (adjusted hazard ratio: 1.63 [95% CI 1.52–1.75]).ConclusionADT is associated with a 1.6-fold increase in the risk of osteoporotic fracture in men with prostate cancer. Densitometry in this population is infrequent and monitoring urgently needs to be improved in order to implement effective fracture prevention.

Utilization of Japanese long-term care-related data including Kaigo-DB: An analysis of current trends and future directions.

Despite high expectations from the government and researchers regarding data utilization, comprehensive analysis of long-term care (LTC)-related data use has been limited. This study reviewed the use of LTC-related data, including Kaigo-DB, in Japan after 2020. There was an increase in studies using LTC-related data in Japan between 2020 and 2021, followed by a stabilization period. The national government provided 13.5% of this data (6.5% from Kaigo-DB), while prefectures and municipalities contributed 85.2%, and facilities provided 1.3%. The linked data used in 90.4% of the studies primarily consisted of original questionnaire or interview surveys (34.6%) and medical claims (34.0%). None of the studies based on Kaigo-DB utilized linked data. In terms of study design, cohort studies were the most common (84.6%), followed by descriptive (5.1%), cross-sectional (3.2%), and case-control studies (1.3%). Among the 138 individual-based analytical descriptive studies, the most frequently used LTC-related data as an exposure was LTC services (26.8%), and the most common data used as an outcome was LTC certification or care need level (43.5%), followed by the independence degree of daily living for the older adults with dementia (18.1%). To enhance the use of LTC-related data, especially the valuable national Kaigo-DB, insights can be gleaned from how researchers effectively utilize municipal and prefectural data. Streamlining access to Kaigo-DB and enabling its linkage with other datasets are promising for future research in this field.